Cost Of Not Caring

In the book, Crazy, by Pete Earley, provides a detailed overview of the mental health system in the United States, as it presents a first hand narrative of Earley’s family journey through the system. The author’s major premise and arguments, in the book, is to highlight the history of mental health, navigation through the judicial system with mental illness, the bureaucracy and policies of hospitals, society views on human rights and client safety, and the impact on the individual, family, and community. The content suggests that human service workers and public health workers should extend their professional lens to advocate for change in the mental health system in the United States.

In order to discuss the Affordable Care Act as it relates to mental health and addiction there needs to be an understanding of the historical development of mental health parity in the United States. There has been a long time struggle to make mental health comparable physical health in health benefits. In 1996 the Mental Health Parity Act (MHPA) was passed due to the crusade efforts of Paul Wellstone and Pete Domenici under the Presidency of Bill Clinton (Frank, Goldman, & McGuire, 2001). The Mental Health Parity act was designed to ensure that large employers that provided health plans did not use lower limits on lifetime dollar amount for mental health in comparison to physical health (Frank, Koyanagi, & McGuire, 1997). In order to continue to build on the MHPA the congress passed the

“The Mental Health Parity and Addiction Equity Act of 2008, also known as MHPAEA is defined as a federal law that prevents group health plans and health insurance issuers that provide mental health or substance use disorder benefits from imposing less favorable benefit limitations on those benefits than on medical or surgical benefits” (Centers for Medicare and Medicaid Services, para 1). Originally, MHPAEA applied only to group health plans and group health insurance coverage, but was “amended by the Patient Protection and Affordable Care Act” to also apply to individual health insurance coverage (Centers for Medicare and Medicaid Services, para 2). “The Mental Health Parity Act of 1996 (MHPA) defined that large group health plans could not impose annual dollar limits on mental health benefits that are less favorable than any limits imposed on medical or surgical benefits” (Centers for Medicare and Medicaid Services, para 6).

Individuals with a mental health illness tend to experience discrimination due to misinformation, assumptions and stereotyping. Many people in our society are not educated on the subject of mental illnesses and often have misconceptions about the conditions and what affects these pre conceived ideas can have on the individual suffering from the

Margaret Vroman, Associate Professor at Northern Michigan University, and former attorney authored the article “Hiring and Firing the Mentally and Psychiatrically Disabled: Advice for HR Professionals.” Ms. Vroman holds a Bachelor of Science in History and Political Science and her Master of Arts in Political Science from Western Michigan University. With an estimated 26.2% of adults suffering from diagnosed mental disorders the effect on the work place can be significant. People with mental disorders are the largest group of disabled individuals in the work force. The 1990 Americans with Disabilities Act (AMERICANS WITH DISABILITES ACT) and subsequent 2009 Americans with Disabilities Amendments Act (AMERICANS WITH DISABILITES ACTAA) prohibits

The article highlights the history of managed care and it’s impact on the delivery of mental health services in the United States. Counselors struggle with balancing the demands of MCOs and the welfare of their clients. The authors highlight that the influence of MCOs create ethical and legal challenges counselors in different areas. Further, the article addressed the issues around DSM codes and MCO regulations of insurance reimbursement. (Braun & Cox, 2005). It is unfortunate that some disorders are not reimbursable by insurance, which leaves the counselor to “chose between an accurate diagnosis that does not provide third party insurance reimbursement or inaccurately diagnosing their client for

The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act (MHPAEA) was enacted on October 3, 2008 as sections 511 and 512 of the Tax Extenders and Alternative Minimum Tax Relief Act of 2008. MHPAEA amends the Employee Retirement Income Security Act of 1974 (ERISA), the Public Health Service Act (PHS Act), and the Internal Revenue Code of 1986 (Federal Register, 2013). The MHPAEA is an extension of the Mental Health Parity Act of 1996, which prohibited annual or aggregate lifetime financial limits on mental health coverage by addressing other restrictions, such as limits on outpatient visits or inpatient days (DOL, 2010). MHPAEA expands parity requirements to treatment limitations, financial requirements, and in- and out-of-network covered benefits (Smaldone, 2010). It also expands the opportunity of mental health parity requirements at the federal level and includes substance use disorders within its scope. Prior to 1996, health insurance coverage for mental illness had historically been less generous than that of other physical illness (Sarata, 2011). Mental health parity is a response to this disparity in insurance coverage, and generally refers to the concept that health insurance coverage for mental health services should be offered equally with covered medical and surgical benefits (Smaldone, 2010).

The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) is an act that requires parity or equality between mental health treatment and medical/surgical treatment covered by private and public insurers with over 50 employees. That means that if an insurance covers mental health issues they can’t impose more stringent limits and financial requirements than medical/surgical coverage. The act was signed into law in 2008 by President George W. Bush. Before the act was signed into law, mental health care was not as affordable or accessible for individuals. (United States Department of Labor, 2016)

In today’s society there is a greater awareness of mental illnesses. With this greater awareness one might assume that there would be a substantial increase in government involvement or funding in the area of mental illness treatment. Unfortunately this isn’t the case in the U.S. today. There are hundreds of thousands of people with mental illness that go untreated. These potential patients go untreated for many reasons. These reasons are discussed in the Time article “Mental Health Reform: What Would it Really Take.

What is left is that we have many citizens who are mentally ill and are not receiving treatment. However the patients who are able to receive treatment are only able to have some treatment covered. Health insurers are responsible for covering the immensely large cost of substantial treatment, a mixture of medication and therapy; since therapy is highly priced, less reliable, and time consuming; patients typically do not receive treatment for therapy. Health insurers would much rather cover medication because it is cheaper, it heals patients faster, and it is more reliable than therapy. However, medication is not made to heal, but to only coax symptoms of a mental illness (Sandberg).

The lack of treatment for mental illnesses — due partly from the stigma with which it is associated with — comes with a number of public issues: economically,

Surveys consistently found that patients presenting with mental illnesses and their families felt they had been treated with a lack of dignity and caring, if not outright contempt by staff in general medical settings. Those with a major mental illness have significantly higher rates of mortality and morbidity from concurrent medical illnesses than the general

Lack of access to mental health care and treatment is one of the top ten reasons that many mental health conditions go untreated. Many private and group health insurance plans only include minimal mental health care coverage or do not incorporate mental health care coverage at all. Over half of adult citizens of the United States of America, who possess a mental illness, do not obtain mental health care treatment. According to the U.S. Department of Health and Human Services, one out of every five adults in America have endured their own mental health difficulty, and one out of every twenty-five American adults suffer from a severe mental illness, such as major depression, schizophrenia, or bipolar disorder. (Top 5 Barriers to Mental Healthcare Access, Social Solutions.com, 2017)

Human Resource Development Professionals are faced with a kaleidoscope of issues relating to the ability of employees to perform their work and how to adjust the workplace environment to meet the needs of disabled individuals in compliance with numerous laws set forth both at the state and federal levels. These laws and the rights to reason accommodations as they pertain to the stigma of employees with mental illness are the bases of this paper. First we will address what issues are most commonly seen by counselors in the workplace. Next, we will preview the five signs of emotional distress. Finally, a brief list of acceptable reasonable accommodations for those individuals who have been deemed

Previous standards, regulations, and benefits in the workplace covering mental illness should be clearly stated and made aware to all employees in a company. Each employee has rights and every employer has a duty to accommodate, especially when it comes to stopping harassment, violence and discrimination. As stated in section 2.3.1 - The creation and impacts of mental illnesses in the workplace, there are two types of harassment: human rights harassment and personal harassment (CUPE, 2014). All harassment is illegal under a number of laws and policies such as the collective agreement, employer policies, human rights laws, occupational health and safety laws, employment standards laws, labor relations laws, workers’ compensation laws, tort